Provider Demographics
NPI:1164772349
Name:HAGEN, SARA J (PMHNP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:J
Last Name:HAGEN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:130 EDINBURGH SOUTH DR
Mailing Address - Street 2:SUITE 208
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-7902
Mailing Address - Country:US
Mailing Address - Phone:919-459-4743
Mailing Address - Fax:919-467-5299
Practice Address - Street 1:2130 FOREST HILLS RD W
Practice Address - Street 2:SUITE A
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-3680
Practice Address - Country:US
Practice Address - Phone:252-265-9200
Practice Address - Fax:252-237-8600
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2013-10-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC208154363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health